China pneumonia outbreak: What we know about ‘overwhelming’ respiratory disease outbreak in hospitals
Chinese hospitals have been inundated with cases of respiratory illness and sick children complaining of pneumonia-like symptoms, prompting increased scrutiny by the World Health Organization.
China’s Ministry of Health said over the weekend that the rise in cases is linked to the overlap of known pathogens and not any new viruses amid fears of another outbreak as the country prepares for its first winter after Covid-19 restrictions are lifted.
There has been a rise in cases associated with viruses such as influenza, rhinovirus, respiratory syncytial virus, or RSV, and adenovirus, as well as bacteria such as mycoplasma pneumoniae, The ministry said in a statement.
Maria Van Kerkhove, acting director of the WHO’s Department of Epidemic Preparedness and Prevention, said the spike in cases appears to be driven by children becoming infected with pathogens from which COVID-19 restrictions have kept them away for two years.
“This is not an indication of new pathogens. This is what is expected. This is what most countries dealt with a year or two ago,” Ms. Van Kerkhove told health news outlet STAT.
Mycoplasma pneumoniae Wang Huaqing, a senior immunization planning expert at the Chinese Center for Disease and Prevention (CDC), said the infection was seen mostly among children aged 5 to 14 years.
“Given that China has had a much longer and harsher lockdown than any other country on Earth, it was expected that the waves coming out of the lockdown would be large in China,” Francois Balloux of University College London told AFP.
China’s Ministry of Health has asked local authorities to increase the number of fever clinics and urged people to wear masks to prevent the spread of the disease.
A children’s hospital in Beijing earlier told state media that at least 7,000 patients were entering the institution daily, far exceeding its capacity.
Last week, the largest children’s hospital in nearby Tianjin received more than 13,000 children in its outpatient and emergency departments. Liaoning Province, located about 690 kilometers northeast of the capital, is also facing high numbers of cases.
The rising number of cases prompted the World Health Organization on Wednesday to issue a formal request for pathology data on respiratory illnesses and pneumonia clusters reported in children.
Chinese health authorities responded by saying they had not found any “unusual or new diseases.” Officials claimed that the large number of patients had not overburdened the country’s hospitals, contrary to local media reports.
China’s National Health Commission also warned that the spread of many pathogens could turn into a major outbreak between this winter and next spring.
The World Health Organization also said on Wednesday that any link between undiagnosed pneumonia clusters and rising cases of respiratory infections is not yet clear.
What happened so far?
Northern China has reported an increase in “influenza-like illnesses” since mid-October, compared to the same period in the previous three years, according to the World Health Organization.
On November 21, the Public System for Disease Surveillance (ProMED) issued a notification regarding reports of “undiagnosed pneumonia.” ProMED, which is run by health experts, earlier in 2019 sounded the alarm about the virus that causes Covid-19.
“With the outbreak of pneumonia in China, children’s hospitals in Beijing, Liaoning and elsewhere were filled with sick children, and schools and classes were on the verge of suspension,” ProMED said, citing a report by FTV News.
“It is not at all clear when this outbreak began because it would be unusual for such a large number of children to be affected so quickly.
“This report indicates a widespread outbreak of an undiagnosed respiratory disease in several regions in China, with Beijing and Liaoning separated by about 800 kilometers.
“The report does not state that any adults were affected, suggesting some were exposed in schools.”
Some parents in Shanghai said Friday they were not overly concerned about the wave of illness.
“Colds happen all over the world,” Emily Wu said outside a children’s hospital. “I hope people are not biased because of the pandemic…but look at this from a scientific perspective.”
What are the symptoms?
According to Chinese health authorities, the outbreak could be linked Mycoplasma pneumoniaeAlso known as “walking pneumonia,” it is a common bacterial infection that usually affects children and has been spreading since May.
Symptoms of walking pneumonia include sore throat, fatigue, and a persistent cough that can last for weeks or months. In severe cases, this can eventually deteriorate into pneumonia.
A Beijing resident, named only as Wei, told FTV News that the infected children “are not coughing or showing any symptoms. They just have a high temperature (fever) and many of them develop lung nodules.”
Health data analysis company Airfinity noted that atypical symptoms were also reported in a hospital in Sichuan Province.
“The fact that only children have been infected indicates that this is most likely an existing pathogen,” Jin Dongyan, a professor at the University of Hong Kong, told Bloomberg.
“If it’s a new pathogen, it should mostly infect adults. It seems to be something adults are used to.”
However, mycoplasma has previously caused epidemics in China every two to four years, with the latest positivity rate in Beijing standing at 40 percent — about 1.3 times higher than its peak in 2019.
How contagious is the disease?
Bruce Thompson, head of the Melbourne School of Health Sciences at the University of Melbourne, told Reuters that preliminary data suggests there is nothing out of the ordinary.
He added: “At this stage, there is no indication that it may be a new strain of Covid.”
“One thing to note is that we can rest assured that the monitoring processes are working, which is a very good thing.”
The World Health Organization suggested people in China get vaccinated, isolate if they feel sick, wear masks if necessary, and get medical care as needed.
“While the World Health Organization seeks this additional information, we recommend that people in China take necessary measures to reduce their risk of respiratory illness,” the agency said.
What do scientists say?
Marion Koopmans, a Dutch virologist who has advised the World Health Organization on Covid, said “more information is needed, especially diagnostic information”.
“We have to be careful.”
“The challenge is to identify outbreaks and determine their cause,” said David Heyman of the London School of Hygiene and Tropical Medicine.
He pointed out that there is a possible background to seasonal respiratory infections.
Brian McCluskey, a public official, said: “I wouldn’t push the pandemic panic button based on what we know so far, but I would be very keen to see the WHO response from China and see the WHO assessment then.” A health expert has also advised the World Health Organization on the pandemic.
“What we see is the WHO’s International Health Regulations system in action,” he said, referring to the rules that govern how countries work with the WHO on potential outbreaks.
Virologist Tom Peacock of Imperial College London said the rising infections were unlikely to occur under the radar, as tools now exist “very quickly” to pick up influenza or emerging coronaviruses.
“(I) suspect it may end up being something more mundane or a combination of things — for example, Covid, influenza, RSV (respiratory syncytial virus) — but hopefully we’ll know more soon,” he said.